You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
Of all the psychiatric symptoms, depression is by far the most common. It has been described (Beck 1967) as the major health problem of today, with it being not only the prominent cause of human misery, but its by product, suicide, a leading cause of death in certain age groups. According to Kline (1964) more human suffering has resulted from depression than any other single disease affecting mankind, while Dunlop (1965) has estimated the prevalence of depression outside of hospitals, as five times greater than that of schizophrenia. When one considers the various diagnostic categories of which depression is an intricate part or is frequently associated, and the number of patients who show, on careful scrutiny, a masked or sub-clinical form, the problem of depression is truly immense.
Depression has been of medical interest for many years, with “melancholia” being described as a separate clinical syndrome over 2000 years ago. Two schools of thought, though, are in vogue as to its etiology. The Kraepelinian concept (1913) theorizes that it is a disease, of some as yet undiscovered organic basis, while the Meyerian concept (1951) theorizes that it is a type of reaction. Psychiatrists seem to lean either to the Kraepelinian viewpoint, or the Meyerian, or else feel that there are two different types of depression; a psychogenic type, following a catastrophic event, as an object loss or a severe emotional frustrating or stressful experience, and an organic type, when no object loss or precipitating experience is recognizable. Although the references on depression are voluminous, there is no clear-cut proof as yet of an actual organic etiology. Biochemical changes have been noted in depressed patients (Polyakova 1961), but similar to changes noted in highly anxious patients, these may be a manifestation of the state, and not an etiologic factor.